§ 1729. Recovery by the United States of the cost of certain care and services
(a)
(1)
Subject to the provisions of this section, in any case in which a veteran is furnished care or services under this chapter for a non-service-connected disability described in paragraph (2) of this subsection, the United States has the right to recover or collect reasonable charges for such care or services (as determined by the Secretary) from a third party to the extent that the veteran (or the provider of the care or services) would be eligible to receive payment for such care or services from such third party if the care or services had not been furnished by a department or agency of the United States.
(2)
Paragraph (1) of this subsection applies to a non-service-connected disability—
(A)
that is incurred incident to the veteran’s employment and that is covered under a workers’ compensation law or plan that provides for payment for the cost of health care and services provided to the veteran by reason of the disability;
(B)
that is incurred as the result of a motor vehicle accident to which applies a State law that requires the owners or operators of motor vehicles registered in that State to have in force automobile accident reparations insurance;
(C)
that is incurred as the result of a crime of personal violence that occurred in a State, or a political subdivision of a State, in which a person injured as the result of such a crime is entitled to receive health care and services at such State’s or subdivision’s expense for personal injuries suffered as the result of such crime;
(3)
In the case of a health-plan contract that contains a requirement for payment of a deductible or copayment by the veteran—
(b)
(1)
As to the right provided in subsection (a) of this section, the United States shall be subrogated to any right or claim that the veteran (or the veteran’s personal representative, successor, dependents, or survivors) may have against a third party.
(2)
(A)
In order to enforce any right or claim to which the United States is subrogated under paragraph (1) of this subsection, the United States may intervene or join in any action or proceeding brought by the veteran (or the veteran’s personal representative, successor, dependents, or survivors) against a third party.
(B)
The United States may institute and prosecute legal proceedings against the third party if—
(i)
an action or proceeding described in subparagraph (A) of this paragraph is not begun within 180 days after the first day on which care or services for which recovery is sought are furnished to the veteran by the Secretary under this chapter;
(c)
(1)
The Secretary may compromise, settle, or waive any claim which the United States has under this section.
(2)
(A)
The Secretary, after consultation with the Comptroller General of the United States, shall prescribe regulations for the purpose of determining reasonable charges for care or services under subsection (a)(1) of this section. Any determination of such charges shall be made in accordance with such regulations.
(B)
Such regulations shall provide that reasonable charges for care or services sought to be recovered or collected from a third-party liable under a health-plan contract may not exceed the amount that such third party demonstrates to the satisfaction of the Secretary it would pay for the care or services if provided by facilities (other than facilities of departments or agencies of the United States) in the same geographic area.
(C)
Not later than 45 days after the date on which the Secretary prescribes such regulations (or any amendment to such regulations), the Comptroller General shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives the Comptroller General’s comments on and recommendations regarding such regulations (or amendment).
(d)
Any contract or agreement into which the Secretary enters with a person under section
3718 of title
31 for collection services to recover indebtedness owed the United States under this section shall provide, with respect to such services, that such person is subject to sections
5701 and
7332 of this title.
(f)
No law of any State or of any political subdivision of a State, and no provision of any contract or other agreement, shall operate to prevent recovery or collection by the United States under this section or with respect to care or services furnished under section
1784 of this title.
(h)
(1)
Subject to paragraph (3) of this subsection, the Secretary shall make available medical records of a veteran described in paragraph (2) of this subsection for inspection and review by representatives of the third party concerned for the sole purposes of permitting the third party to verify—
(i)
For purposes of this section—
(1)
(A)
The term “health-plan contract” means an insurance policy or contract, medical or hospital service agreement, membership or subscription contract, or similar arrangement, under which health services for individuals are provided or the expenses of such services are paid.
(B)
Such term does not include—
(i)
an insurance program described in section 1811 of the Social Security Act (42 U.S.C. 1395c) or established by section 1831 of such Act (42 U.S.C. 1395j);
(ii)
a State plan for medical assistance approved under title XIX of such Act (42 U.S.C. 1396 et seq.);